老年供肾亲属肾移植疗效和安全性分析

Efficacy and safety of elder donor in living kidney transplantation

目的:探讨老年供肾亲属肾移植的疗效和安全性。方法:对我院66例行活体肾移植的供受者资料进行回顾性分析。供者50岁以上24例,其中8例次供者术前检查存在轻度医学异常(包括镜下血尿4例,高血压2例,肥胖1例,结石1例),比较老年供者和非老年供者术前总肾小球滤过率(GFR),手术前后血清肌酐(SCr),留存肾GFR以及并发症等情况。同时对二组受者的手术前后SCr,内生肌酐清除率(Ccr)、并发症、人肾存活率进行比较。结果:两组供者术后总体肾功能恢复良好,无显著性差异。但50岁以上组术后3月以上留存肾GFR显著低于50岁以下组(P<0.05)。两组受者在术后1年内SCr、Ccr、DGF、急性排斥和并发症均无显著性差异。结论:老年供者选择需十分谨慎。术前全面而彻底评估,严格控制纳入标准,其安全性和疗效良好。

Objective：To investigate the effecacy and safty of elder living kidney donors and recipients. Methodology：A retrospective analysis of sixty-six living kidney donors was performed from Feb,2004 to Aug,2007.The age of 24 donors was over 50 years old.8 of them accompaniment isolated medical abnormalities（IMA） include microhaematuria（4 cases）,hypertension（2 cases）,obesity（1 cases） and nephrolithiasis（1 cases）.The level of serum creatinine（SCr） before and after surgery,glomerular filtration rate（GFR） before and after surgery,complications were observed and compared both donors and recipients. Results：The level of SCr and GFR befor surgery had no significant difference between elder and yonger donor groups.The level of SCr over 90 days postoperation also had no significant difference in two groups.However,GFR over 90 days postoperation in elder donors were lower than that in younger donors（P〈0.05）.The complications in two groups had no signifficant difference.For recipients,Ccr and SCr over 1 year postoperation had no significant difference between two groups. Conclusion：Donating a kidney is safe to elder donor.The sellection of elder donors must be careful.Thorough and comprehensive evaluating procedure is the key to safty and good progonosis for donors and recipients.